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Amikacin

[Amikacin photo]

 

KEY POINTS

  • Amikacin is an aminoglycoside antibiotic that inhibits bacterial growth in susceptible organisms by interfering with bacterial protein synthesis
    • Binds to 30S and 50S ribosomal subunits, resulting in a defective bacterial cell membrane
    • Exhibit concentration-dependent bacterial killing (higher peak levels means more bacterial killing)
    • Has activity against many organisms, including susceptible Pseudomonas aeruginosa
  • Most commonly given intravenously
    • Can be dosed multiple times per day, once daily or a few times per week IV
      • For non-tuberculosis Mycobacteria infections, higher doses at extended intervals are sometimes used (e.g., up to 25mg/kg IV three times weekly)
      • The general dosing range for daily IV amikacin is 7 to 14mg/kg
      • Lower doses can usually be used for urinary tract infection, since the concentrations in the urine are so high
      • Dosing is frequently done based upon ideal body weight, see resources below for dosing guidance
    • Nephrotoxicity and ototoxicity are potential side effects
      • Adjust doses & frequency for kidney impairment
    • Monitoring drug levels is frequently indicated
  • An inhaled liposomal amikacin product was FDA-approved October 1, 2018 and is called Arikayce
    • The recommended dosage in adults is once daily oral inhalation of the contents of one 590 mg/8.4 mL vial
    • Consider pre-treatment with bronchodilators
    • Has only been studied for refractory MAC lung disease
    • See Arikayce package insert here for more details

RESOURCES

  • Amikacin IV Package Insert
  • Arikayce Package Insert
  • Jackson Memorial / University of Miami Antibiotic Dosing Card
  • Nebraska Stewardship Program PK Training Content
  • PK-PD Compass
  • IDSA Practice Guidelines
  • Surgical Prophylaxis Guidelines
  • Review of Population PK for Amikacin in Critically Ill Patients (2017)
  • Amikacin for ESBL+ UTI (2016)
  • Systematic Review of Amikacin Therapeutic Drug Monitoring in Adults (2016)

Free Antibiotic Cheat Sheet

Study Guide

  • Pharmacotherapy Study Guide
  • Acyclovir
  • Albendazole
  • Amikacin
  • Aminoglycosides
  • Amphotericin B
  • Amoxicillin
  • Amoxicillin-Clavulanic Acid
  • Ampicillin
  • Ampicillin-sulbactam
  • Anidulafungin
  • Artesunate
  • Atovaquone
  • Azithromycin
  • Aztreonam
  • Bacitracin
  • Baloxavir marboxyl (Xofluza)
  • Bamlanivimab
  • Baricitinib
  • Bezlotoxumab
  • Casirivimab and Imdevimab
  • Caspofungin
  • Cefazolin
  • Cefepime
  • Cefiderocol
  • Ceftaroline
  • Ceftazidime
  • Ceftazidime-avibactam
  • Ceftolozane-Tazobactam
  • Ceftriaxone
  • Cefoxitin
  • Cephalexin
  • Ciprofloxacin
  • Clarithromycin
  • Clindamycin
  • Colistin (colistimethate)
  • Cycloserine
  • Dalbavancin
  • Daptomycin
  • Delafloxacin
  • Dicloxacillin
  • Doripenem
  • Doxycycline
  • Elbasvir/ grazoprevir
  • Eravacycline
  • Ertapenem
  • Erythromycin
  • Famciclovir
  • Fidaxomicin
  • Fluconazole
  • Flucytosine
  • Foscarnet
  • Fosfomycin
  • Ganciclovir
  • Gentamicin
  • Glecaprevir/ Pibrentasvir
  • Imipenem-cilastatin
  • Imipenem-cilastatin-relebactam
  • Isavuconazole
  • Itraconazole
  • Ivermectin
  • Ledipasvir/sofosbuvir
  • Lefamulin
  • Letermovir
  • Levofloxacin
  • Linezolid
  • Meropenem
  • Meropenem-vaborbactam
  • Metronidazole
  • Methenamine
  • Micafungin
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  • Nafcillin
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  • Penicillin Skin Test
  • Phenazopyridine
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  • Polymyxin B
  • Posaconazole
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  • Remdesivir
  • Ribavirin
  • Rifabutin
  • Rifampin
  • Secnidazole
  • Sofosbuvir/ velpatasvir/ voxilaprevir
  • Sulfadiazine
  • Sulfamethoxazole-Trimethoprim (Bactrim)
  • Tedizolid
  • Telavancin
  • Tigecycline
  • Tobramycin
  • Tocilizumab
  • Valacyclovir
  • Valganciclovir
  • Vancomycin
  • Voriconazole
  • Zidovudine
  • Zoster vaccine recombinant, adjuvanted (Shingrix)

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